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“For a thousand years, we talked about the operating theater,” said Dr. Mark Siegler, a medical ethicist at the University of Chicago and an author of a recent study on surgeon-patient communication during awake procedures, published in the American Journal of Surgery. “And for the first time, in recent years the patient has joined the cast.”

Choosing to watch your own surgery is one more manifestation of the patient autonomy movement, in which patients, pushing back against physician paternalism, are eager to involve themselves more deeply in their own medical treatment.

But Dr. Alexander Langerman, the senior author of the communication study and a head and neck surgeon on the faculty of Vanderbilt University Medical Center in Nashville, said that a patient’s decision to remain awake during an operation also reflects a growing suspicion, generally, of authority figures. Noting how pedestrians pull out smartphones to capture police activity, he said, “There’s an element in that for patients, too. The occasional scandals that emerge while patients are sedated continue to erode their trust in us.”

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Image: By Arthroscopist – Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=3960388

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